Congress Awakens to AIDS With a Convert's Zeal

By SHERYL GAY STOLBERG

Published: May 12, 2002

WASHINGTON, May 11—
Two decades into the global AIDS epidemic, an unlikely alliance of lawmakers is pressing President Bush to increase spending by hundreds of millions of dollars this year to help foreign nations grapple with the disease.

The Bush administration has budgeted $780 million for the global AIDS fight this year. On Thursday, however, Republicans on the House Appropriations Committee voted to add $200 million in global AIDS money to an emergency measure for domestic security and military spending. The White House had not asked for the money.

Next week, the Senate Appropriations Committee is to vote on its version of the emergency spending bill and will consider adding as much as $700 million for global AIDS.

Republican and Democratic lawmakers predict the total will be $500 million when the House and Senate bills are reconciled, which would mean nearly $1.3 billion to fight the disease globally. The money is to be allocated by Sept. 30, with more likely next year.

''It took tens of millions of people being infected and dying before our political system woke up to those realities,'' said the economist Jeffrey D. Sachs, who recently served as chairman of a World Health Organization panel that examined the economic impact of AIDS. ''But there is no doubt it is waking up now.''

Among those who have undergone an awakening is Representative Richard A. Gephardt, the House minority leader, who talks with passion about a trip he took to Africa in 1999. Mr. Gephardt, a Missouri Democrat, led a Congressional delegation to South Africa, Nigeria and Zimbabwe, intending to learn about economic and political conditions. Instead, he said, he came away with a single message: ''AIDS, AIDS, AIDS, AIDS. I came away knowing and believing that this is the moral issue of our time.''

Now, Mr. Gephardt is calling for the United States to spend $2 billion a year to fight the AIDS pandemic. A few years ago, he would have been laughed out of official Washington for such a suggestion. Today, however, Mr. Gephardt has a surprising partner in his fight: Senator Jesse Helms, the North Carolina Republican, who also wants more money, though not billions, for global AIDS.

Mr. Helms, 80, has frequently denounced foreign aid as ''a rathole'' and has infuriated gay people by asserting that homosexuals were to blame for the spread of AIDS in this country. Yet as he prepares to retire, the senator is calling for $500 million for medicines that would prevent expectant mothers infected with the human immunodeficiency virus from passing it on to their babies.

The reasons for the change in Congressional sentiment are varied, and even proponents of more spending disagree on how much money is needed and precisely where it should go. Some lawmakers have come to embrace the disease as a children's issue, citing predictions that the number of AIDS orphans will increase to 40 million in 10 years.

Sandra Thurman, the former top AIDS official in the Clinton administration who runs a nonprofit group, the International AIDS Trust, said she began pitching the concept to Congress as early as 1999.

''If you can't get Democrats and Republicans to agree on everything,'' Ms. Thurman said, ''you can get them to agree on children.''

Others, like Senator Joseph R. Biden Jr., Democrat of Delaware, chairman of the Senate Foreign Relations Committee, see the disease as a national security threat, creating political and economic instability that will breed the next generation of terrorists. Former President Bill Clinton, who has made combating global AIDS a priority of his ex-presidency, has made this argument in a series of speeches.

Some lawmakers, notably Mr. Helms, have credited Bono, the Irish rock star who has become something of a cult figure in Washington with his pleas for more aid to fight global poverty and disease. Some credit Kofi Annan, the United Nations secretary general, who last year called for a new global fund to fight AIDS. The fund awarded its first grants last month.

Still others, like Mr. Gephardt, have witnessed the devastation up close and cannot quite get over what they saw.

''It is a life-changing experience,'' Mr. Gephardt said, ''to go there and confront physically what it means to have 22 million people H.I.V. positive without any drugs, without any real infrastructure to deliver drugs. We went to a hospital in Johannesburg and we went through pediatrics wards and we learned that about half the babies born in the hospital are H.I.V. positive. I asked, 'How long will these children live?' Some were in preemie incubators. And they said, 'Less than a year.' ''

Infection with the AIDS virus is now the leading cause of death in sub-Saharan Africa, according to UNAIDS, an arm of the World Health Organization. On Friday, the agency reported that 6,000 young people age 15 to 24 and 2,000 children under 15 were infected with H.I.V. every day.

Yet the agency said medicines to prevent mother-to-child transmission of the virus reached fewer than 5 percent of women in sub-Saharan Africa.